A white spot on the eyeball can be an unsettling discovery, prompting concerns about eye health. While various causes exist, from minor irritations to serious conditions, a professional medical diagnosis is always advisable. Comparing a visible white spot to online images can offer initial insights, but only a thorough examination by an eye care professional can determine the precise cause and guide management. This article offers general information and does not substitute for professional medical advice.
Causes of White Spots on the Surface of the Eyeball
White spots on the eye’s surface often involve the cornea, the clear, dome-shaped front part of the eye, or the conjunctiva, the transparent membrane covering the white part. These conditions manifest distinctly, offering visual clues about their nature.
Corneal Ulcer
A corneal ulcer is an open sore on the cornea, appearing as a gray-to-white opaque spot. Symptoms often include pain, redness, excessive tearing, and a feeling of something lodged in the eye. Causes include bacterial, viral, or fungal infections, eye injuries, or complications from extended contact lens wear, particularly with improper hygiene.
Keratitis
Keratitis, an inflammation of the cornea, can cause a white spot or hazy appearance on the eye’s surface. This condition is closely related to corneal ulcers, as it can lead to ulcer formation. Infections are a common cause, and contact lens wearers face an elevated risk if they do not follow proper cleaning and wearing schedules.
Pinguecula and Pterygium
Pinguecula and pterygium are distinct growths on the conjunctiva, often linked to prolonged exposure to UV radiation, wind, and dust. A pinguecula appears as a yellowish, slightly raised bump on the white part of the eye near the nose, not extending onto the cornea. In contrast, a pterygium is a fleshy, wedge-shaped growth that can begin on the conjunctiva and grow across the cornea.
Corneal Scar
A corneal scar appears as a milky or opaque patch on the cornea, resulting from a healed injury or severe infection. This scarring can block or distort light entering the eye, potentially decreasing vision. Deeper scratches, chemical burns, or untreated infections are common causes of such permanent corneal changes.
Causes of Whiteness Originating Inside the Eye
Whiteness originating deeper within the eye, behind the clear surface, indicates conditions affecting internal structures. These conditions alter how light passes through the eye, creating a visible change in the pupil or overall eye appearance. Such internal changes require careful evaluation to understand their impact on vision.
Cataracts
Cataracts involve a clouding of the eye’s natural lens, located inside the eye behind the pupil. As a cataract progresses, it can make the pupil appear cloudy, gray, or entirely white instead of its usual black. This condition is common in older adults, though it can also occur congenitally in infants or develop due to eye trauma or certain medical conditions.
Corneal Dystrophies
Corneal dystrophies are genetic conditions where abnormal material accumulates in one or more layers of the cornea. These accumulations can manifest as white dots, lines, or cloudy patches within the corneal tissue. Many are inherited, affect both eyes, and progress gradually, sometimes impacting vision over time.
Understanding the White Pupil Reflex in Photos
When a child’s eye appears white in flash photographs, instead of the typical red reflex, it is known as leukocoria or “white pupil reflex.” This occurs when light from the camera flash reflects abnormally off an internal eye structure, rather than the retina producing the usual reddish-orange glow. While sometimes an artifact of the photo angle, leukocoria can indicate serious underlying eye conditions, particularly in children.
Retinoblastoma
Retinoblastoma, a rare eye cancer primarily affecting young children, is a concern when leukocoria is observed. The white reflex is a common sign of this cancer, often being the first symptom noticed by parents in photographs. Early detection is crucial, as prompt treatment can improve outcomes and prevent the cancer from spreading.
Coats’ Disease
Coats’ disease is another condition that can cause leukocoria, characterized by abnormal development of retinal blood vessels, leading to leakage and retinal detachment. This rare disorder mostly affects young males and usually impacts only one eye. The white reflex is due to abnormal vascular changes and fluid accumulation behind the retina.
Any instance of a white pupil reflex in photos of a child should prompt an immediate consultation with an ophthalmologist. Even if benign, ruling out serious conditions like retinoblastoma or Coats’ disease through a comprehensive eye examination is necessary. Prompt evaluation leads to early diagnosis and intervention, which benefits managing these conditions.
Professional Diagnosis and When to Seek Immediate Care
Discovering a white spot on the eye warrants professional medical evaluation to accurately diagnose the cause and initiate appropriate management. An eye care professional begins with a detailed discussion of symptoms and medical history. This initial assessment helps narrow down potential causes and guides the subsequent examination.
The diagnostic process includes a visual acuity test to assess vision clarity and a slit-lamp examination, which uses a specialized microscope for a magnified view of eye structures. To identify surface issues like ulcers or abrasions, a fluorescein eye stain may be applied; this orange dye temporarily highlights damaged areas under blue light. If an infection or serious condition is suspected, a tissue sample may be taken for laboratory analysis.
Certain accompanying symptoms with a white spot indicate a need for immediate medical attention. These include a sudden change or loss of vision, which can signal a rapidly progressing condition. Severe eye pain, especially if sudden or quickly intensifying, also necessitates urgent care.
Other concerning signs include thick, yellowish, or greenish eye discharge, suggesting an active infection. High sensitivity to light, persistent eye redness, or a constant sensation of a foreign body in the eye also warrant prompt medical help. Any new or changing white spot, particularly when accompanied by these symptoms, should be evaluated by an eye care professional without delay.